What do Republican election wins mean for healthcare reform?

Republicans scored big wins in yesterday's midterm elections, and today's headlines are full of analysis of what those victories mean for the future of the Affordable Care Act. 

First, Republicans prevailed in areas of the country where the uninsured rate fell as a result of the healthcare reform law, The New York Times reported. Arkansas, Kentucky and West Virginia elected GOP Senate candidates who oppose the ACA. And Arkansas elected Republican supermajorities in its legislature and a Republican governor, which might threaten Medicaid expansion in the state.

Overall, appreciation for new health insurance coverage didn't drive ballot box behavior. A warehouse packer in Kentucky who gained Medicaid coverage, for example, described herself as "born and raised Republican" and told The Times, "I ain't planning on changing now."

The new Republican majority in the U.S. Senate faces the challenge of appeasing conservatives who want the ACA repealed while showing voters that the GOP agenda includes more than this one-track-pony issue, according to the National Journal.  

On deck Senate Majority Leader Mitch McConnell (R- Ky.) pledged to use the budget reconciliation process to pass anti-ACA measures focused on unpopular aspects of the law.  

One example is repealing the tax on medical devices, which President Barack Obama might sign because it isn't central to healthcare reform. There may also be proposed changes to the employer mandate such as a new definition of a full-time employee. Another ACA-related item that may head for the chopping block is the Independent Payment Advisory Board, a panel responsible for putting the brakes on Medicare spending growth. President Obama hasn't named anyone to this controversial panel yet, the Journal added.    

What the Republicans aren't apt to do in this political climate is introduce an alternative healthcare reform bill even though some conservatives want one, the Journal noted.        

For more:
- here's the National Journal article
- read The New York Times article